Reintegration Therapy

In high-conflict divorce, children sometimes become distant from one or both parents. This is especially the case in highly litigious cases where custodial changes and/or modifications to custody have been filed, re-filed, requested, denied, allowed, etc. When allegations of abuse are present and Health & Welfare becomes involved, families frequently become even more polarized with the child(ren) facing the greatest difficulty in terms of resolution. Parents may be ordered by a judge to participate in "Reintegration Therapy" (or "Reunification Therapy") once the case plan or allegations are resolved, wherein children and parents can be reintroduced to one another in a therapeutic, predictable, and safe manner. In these situations, it is very important to understand that a “one size fits all” approach is NOT always the best strategy, nor is it always therapeutically indicated. In my practice, I spend quite a bit of time educating parents on the various approaches we may need to take in order to repair relationships and resolve historical issues. This type of family therapy is very time-intensive; however, I have found the best outcomes to be when BOTH parents enter into this work (by court order or not) with an open mind, an ability to accept and fully integrate feedback, and a willingness to be patient and flexible. These are not simple requests given the high intensity of emotion, and even further reinforces the need to take ample amounts of time in the process.

There are two main interventions that are commonly used to assist in maintaining a bond or relationship between an estranged parent and child:

Reintegration Therapy

The history of conflict common in these cases typically results in one of the parents assuming the role of "protective" parent, and the other becoming estranged (i.e., absent) from the child’s life. The main goal of reintegration is to reintroduce a parent back into a child’s life in a safe, controlled, and therapeutic manner, so that a new and secure bond may become established. This type of family-systems therapy takes a great deal of time and is generally not covered by insurance although clients are encouraged to check with their individual plans for reimbursement options. The process begins with a thorough review by a qualified clinician of any court orders, parenting plans, settlements, court motions, CPS or child welfare documentations, any police reports, prior psychological evaluations or mental health records, as well as common information for all individuals and children involved. This ensures that the clinician is well aware of the entire situation to better create a safe and unique treatment plan for the family. Next, the clinician will meet individually with each parent and the child(ren) to further obtain accurate and specific information from each person involved.

As stated, there is NOT one way to perform this type of therapy and is entirely dependent on the dynamics of the individuals involved. A customized strategy must be developed and almost always includes (to greater and lesser degrees) the custodial (or "protective") parent who is absolutely critical in these cases. The clinician works with the custodial parent to better understand the fears (rational and irrational) and hopefully guides and educates them with regard to their own participation, strong influence, and involvement with the estranged parent in terms of the ongoing impact on the child. The clinician will typically meet in an alternating fashion with parent and child(ren) in either individual or joint sessions. In some cases, it is necessary to conduct these appointments via live "chat" sessions (no video) or via Skype sessions (with video) and involve other therapists in the process. Again, this is a very time-intensive process but, if done well, can yield positive outcomes.

Therapeutic Supervised Visitations

Frequently, high-conflict families who are at risk for domestic violence, physical or verbal abuse, and parents with a history of poor parenting skills due to mental illness and/or substance use require the use of therapeutic supervised visitation (TSV) programs. The purpose of TSV is to enable an ongoing relationship between the non-custodial parent and child by impartially observing their contact in a safe and structured environment. Another purpose of TSV is to allow a safe and educational learning experience for the non-custodial parent. These programs have systems in place in order to intervene and correct behaviors, therefore teaching the parent appropriate parenting skills by staff within the office or off-site facility. TSV, unlike reintegration, does not in and of itself assist in the long term goal of achieving a healthy relationship between the non-custodial parent and the child; however, it is often an integral part of the reintegration process, especially early on in the work.

Essentially--and simply put--the primary difference between 'TSV' and 'reintegration' is that with TSV, the therapist is facilitating a hard conversation between a parent and child. Sometimes it's explaining why the parent was away for so long (prison, job change, issues related to mental illness) for which the primary custodial parent is not in a position nor prepared to facilitate. With reintegration work, there is frequently some force at work contributing to a child being highly resistant or refusing to spend time with a parent that is NOT related to any form of abuse or neglect. The child will often present with rigid, polarized, dependent, and highly entrenched perspectives of their parents. The therapy, therefore, tends to focus on challenging old thoughts, feelings, and behaviors so that the children will not remain stuck with cognitive distortions and antiquated problem-solving strategies.

Last word on "Parental Alienation" Some parents believe that the "protective" parent has so much influence on the child that he/she has "brainwashed" the child to hate the non-custodial parent. Courts typically do not acknowledge the existence of a "syndrome," but there are certain behaviors that exist which may fall under the category of "alienating behaviors." A good clinician will employ techniques which will effectively address these issues, all the while staying cognizant of the fact that one of the most serious challenges in the reintegration process is where there have been multiple, unsuccessful attempts at reintegration. These situations must be handled carefully, as repeated attempts have the potential to be detrimental to the healthy development of the child. Finally, issues of estrangement are categorically different than issues of alienation and must be handled as such.

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